Int
ern
at
i
onal
Journ
al of
P
u
bli
c Hea
lt
h S
c
ie
nce (IJPH
S)
Vo
l.
8
, No
.
4,
Dec
2019
, p
p.
39
1
~
399
IS
S
N: 22
52
-
8806,
DOI: 10
.11
591/ij
phs.
v8
i
4.
20370
391
Journ
al
home
page
: htt
ps://
ww
w.i
aesco
re
.c
om
/j
our
nals/
ind
ex.
php/IJP
H
S
Health
ed
ucation
imp
rove behavio
r and sel
f
-
effic
acy on
personal
hygiene
amon
g
ch
ild
re
n
with inte
llectu
al d
isability
Ti
tiek Hiday
ati
1
, Akro
m
2
, Indri
Nuras
a
3
,
Er
via
n
a
4
1
Depa
rtment of
Epi
demiolog
y
,
F
amil
y
Medi
ci
ne
and
Publi
c
He
al
t
h,
Medi
ci
n
e
a
nd
Hea
lt
h
Scie
n
ce
Facul
t
y
,
Univer
sita
s Muh
amm
adiy
ah
Yogy
ak
arta, Indone
s
ia
2
Depa
rtment of
Pharm
ac
olog
y
,
Pharm
acy
Facu
lty
,
Univer
si
ta
s A
hm
ad
Dahla
n
,
In
donesia
3
,4
Magiste
r
Man
age
m
ent
of
Nurs
ing,
Univ
ersitas
Muham
m
adi
y
ah Yog
y
ak
art
a
,
Ind
onesia
Art
ic
le
In
f
o
ABSTR
A
CT
Art
ic
le
history:
Re
cei
ved
Sep
14
, 201
9
Re
vised
Oct
2
0
, 2
01
9
Accepte
d
Nov 27
, 201
9
Personal
h
y
gie
n
e
is
one
of
th
e
basic
hum
an
ne
eds
and
m
ust
be
kept
c
lean
,
inc
ludi
ng
sc
al
p
and
h
ai
r
,
e
y
es
,
nose,
ea
rs
,
nails
of
hands
and
f
ee
t
,
skin
and
over
all
bod
y
c
ar
e.
Hea
lt
h
edu
ca
t
ion
on
per
sona
l
h
y
gi
ene
is
stil
l
c
once
rn
not
onl
y
for
he
al
th
y
chi
ldr
en
bu
t
al
so
for
ch
il
dre
n
with
disabi
litie
s
.
One
of
the
wa
y
s
is
with
audi
ovis
ual
m
et
hods.
Th
i
s
stud
y
ai
m
ed
to
anal
y
z
e
th
e
eff
e
ct
of
he
al
th
educ
a
ti
on
on
p
e
rsonal
h
y
gie
n
e
with
audi
ov
isual
m
et
hods
.
The
stud
y
design
used
was
pre
-
ex
per
iment
wi
thou
t
a
control
group
.
T
he
num
ber
of
sam
ple
s
was
30
using
total
sam
pli
ng
te
chn
iq
ue.
Know
le
dge
of
per
sona
l
h
y
g
ie
ne
bef
o
re
hea
l
th
educat
ion
(pre
-
te
st)
was
m
ostl
y
insuffi
cient
c
at
egor
y
,
after
b
ei
ng
give
n
hea
l
th
edu
ca
t
ion
(post
-
te
st)
m
ai
n
l
y
was
in
prop
er
group
.
T
he
p
re
-
te
st
a
tt
i
tude
was
in
low
c
at
eg
or
y
,
and
th
e
post
-
te
st
was
st
il
l
the
sam
e.
Pre
-
te
st
a
nd
post
-
t
es
t
of
beha
v
ior
wer
e
m
ostl
y
b
ei
ng
pr
ac
t
ic
ed
.
Pre
-
te
st
and
post
-
t
est
of
s
el
f
-
eff
ica
c
y
were
in
low
c
at
e
gor
y
.
The
re
was a
n
inf
lue
n
ce
of
h
ea
l
th
educ
a
ti
on
on
per
sona
l
h
y
gi
ene
with
au
d
iovi
sual
m
et
ho
ds
on
th
e
l
evel
o
f
knowledge
in
i
nte
llec
tual
l
y
disabl
ed
chi
ldr
e
n
(p<
0
.
05)
,
but
the
re
was
no
ef
fec
t
on
at
t
it
udes
,
b
eha
v
iors,
and
se
lf
-
eff
icac
y
in intellect
u
al
l
y
disabled
chi
ldr
en.
Ke
yw
or
d
s
:
Atti
tud
e
Be
hav
i
or
In
te
ll
ect
ual d
is
abili
ty
Kno
wled
ge
Pers
on
al
hygie
ne
Copyright
©
201
9
Instit
ut
e
o
f Ad
vanc
ed
Engi
n
ee
r
ing
and
S
cienc
e
.
Al
l
rights re
serv
ed
.
Corres
pond
in
g
Aut
h
or
:
Akro
m
,
Dep
a
rtm
ent o
f Pha
rm
acolog
y,
Ph
a
rm
acy
Facu
lt
y,
U
niv
e
rsita
s Ahm
ad
Da
hl
an,
Kap
a
s
9
Roa
d,
Sem
aki, U
m
bu
lhar
j
o,
Yogyak
arta 5
5166,
Indon
e
sia
.
Em
a
il
:
akr
om@p
har
m
.u
ad
.a
c.id
1.
INTROD
U
CTION
The
num
ber
of
Ind
onesi
ans
w
it
h
disa
bili
ti
es
is
est
i
m
at
ed
at
2.45%
,
a
nd
ar
ound
39.
97%
of
them
hav
e
m
or
e than
one
disabili
ty
o
r
di
sabili
ty
[
1
-
2
]
. Th
e Cent
ral Stat
ist
ic
s A
gen
cy
p
ubli
sh
e
d
S
use
nas data
, s
ta
ti
ng
t
hat
9.9
m
illi
on
I
ndonesi
a
n
child
ren
a
re
c
hildr
e
n
wit
h
sp
e
ci
al
needs
in
t
he
c
at
ego
ry
of
pe
r
so
ns
with
disa
bili
ti
es
.
Data
on
pe
ople
with
so
ci
al
welfare
pro
ble
m
s
in
2016
de
scribes
t
hat
per
s
ons
with
disabili
ti
es
bas
ed
on
reg
i
on
s/
district
s/c
it
ie
s
in
Yogyaka
rta
S
pec
ia
l
Prov
i
nce
(
Ku
l
on
P
r
ogo,
Ba
nt
ul,
G
unung
Ki
du
l,
Sle
m
an
,
and
Yogyaka
r
ta
)
we
re
26
177
pe
op
le
,
s
pe
ci
fical
ly
fo
r
t
he
ci
ty
of
Y
ogya
ka
rta
nu
m
ber
i
ng
17
25
pe
op
le
.
The
i
ntell
ect
ua
l
cat
ego
ry
a
nd
ty
pe
of
m
ental
retard
at
io
n
dis
abili
ty
nu
m
ber
ed
71
81
pe
op
l
e
[
3
]
.
Chil
dr
e
n
with
disabili
ti
es
or
chi
ldre
n
with
i
ntell
ect
ual
disa
bili
t
ie
s
hav
e
de
la
ys
an
d
li
m
itati
on
s
in
al
l
de
velo
pm
ents
s
o
t
hat
the
child
has
diff
ic
ulty
do
i
ng
sel
f
-
care
[
4
]
,
s
om
e
sel
f
-
ski
ll
s
su
ch
as
ea
ti
ng
,
us
in
g
the
toil
e
t,
wear
in
g
a
nd
rem
ov
ing
cl
ot
hes,
pe
rs
on
al
hygiene
,
a
nd
decorati
ng
[
5
].
Ba
sic
per
s
on
al
hygie
ne
t
ha
t
m
us
t
be
c
onsidere
d
include
s scal
p and hai
r
car
e, e
ye
s,
nose,
ears
,
h
a
nds a
nd f
eet
, s
ki
n
a
nd
ov
e
r
al
l body care
[
6
]
.
Pers
on
al
hy
gie
ne
i
n
nur
sin
g
i
s
on
e
of
the
ba
sic
hum
an
nee
ds
.
Pe
rs
on
al
hy
giene
is
a
p
ra
ct
ic
e
carrie
d
ou
t
by
s
om
eone
in
m
ai
ntaining
or
ca
rin
g
for
sel
f
-
hy
giene
,
su
c
h
as
m
ai
nt
ai
nin
g
the
cl
eanli
ness
of
hair,
ey
es,
ears,
nose,
m
ou
th,
nails,
ge
ni
ta
l,
and
cl
ean
a
pp
ea
ra
nce.
Per
so
na
l
hy
giene
t
hat
is
car
ried
out
on
c
hild
ren
is
pa
rt
of
the
m
ai
ntenan
c
e
e
ffo
rt
in
him
,
wh
ic
h
in
cl
ud
es
sa
nitat
i
on
a
nd
he
al
th
to
get
ph
ysi
cal
fitness
a
nd
prevent
the
em
erg
ence
of
disease
[
7
]
.
Pers
on
al
hygie
ne s
hould
be a
con
ce
r
n n
ot
on
ly
fo
r
healt
hy
c
hildr
e
n (
w
ho
a
re
not
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SSN
:
2252
-
88
06
In
t.
J.
Publi
c He
al
th Sci. V
ol.
8
,
No.
4
,
Dece
m
ber
201
9
:
39
1
–
3
99
392
disable
d)
but
a
lso
for
c
hild
re
n
with
disa
bili
ti
es.
Chil
dre
n
with
disa
bili
ti
e
s
ha
ve
the
ri
ght
to
get
at
te
nti
on
a
nd
protect
ion
f
rom
fa
m
il
y,
co
m
m
un
it
y,
and
governm
ent
fo
ll
owin
g
La
w
Num
ber
23
of
20
02
a
bout
c
hild
protect
io
n
and
La
w
Nu
m
ber
36
of
2009
ab
ou
t
healt
h.
Pers
on
al
hygie
ne
ca
re
ai
m
s
to
im
pr
ov
e
one'
s
healt
h
sta
tu
s
a
nd
as
a
form
o
f disea
s
e preve
ntio
n
[
3
,
7
-
8
].
Cl
eanli
ness
it
s
el
f
has
bee
n
re
gu
la
te
d
in
th
e
Qur'
an
a
nd
Al
-
Had
it
h,
pe
rson
al
hygie
ne
su
c
h
as
bathi
ng,
cl
eaning
cl
ot
he
s,
e
ven
be
f
ore
wors
hip
in
g,
w
hich
is
cl
e
anin
g
yo
ursel
f
by
was
hing.
This
is
f
ound
in
T
he
QS.
Al
Ba
qar
a
h
(
2)
:
22
2
,
w
hich
m
eans:
"Ver
il
y,
Alla
h
li
kes
th
os
e
w
ho
re
pen
t
an
d
li
kes
t
hose
w
ho
purify
them
sel
ves
."
G
od
'
s
Wor
d
i
n
QS
.
Al
Mu
dda
sir:
4
-
5
wh
ic
h
m
eans:
"A
nd
c
le
an
yo
ur
cl
othe
s.
And
sin
,
le
ave
it
".
Al
Had
ist
:
"F
r
om
Abu
Ma
li
k
Al
-
As
har
ia
ri
sai
d
Ra
su
l
u
ll
ah
SAW
sai
d:
"Sancti
ty
is
a
co
ndit
ion
of
fait
h
.
"
(H
R.
M
us
li
m
).
"Islam
is
a
rel
igion
t
hat
is
cl
ean/h
oly,
so
yo
u
sho
uld
m
ai
nt
ai
n
cl
eanli
ness.
Su
rely
yo
u
wi
ll
not
enter
hea
ve
n,
excep
t
f
or
th
ose
w
ho
a
re
ho
l
y
"(H
R.
Ba
iha
qi).
U
nclean
a
nd
dirt
y
if
le
ft
at
ta
ched
to
th
e
bo
dy
,
it
will
cause
disease
or
inte
rf
e
ren
ce
.
Ba
thi
ng
or
pe
rfor
m
ing
a
blu
ti
on
s
o
that
the
body
beco
m
es
cl
e
an
is
so
m
et
hin
g
that
has
been
ta
ught
in
Islam
[
9
]
.
T
he
P
rop
het
Mu
ham
m
ad
was
a
m
esseng
e
r
w
ho
was
ver
y
c
on
c
ern
e
d
about
he
al
th
a
nd
cl
ea
nliness
.
Ra
su
lull
ah
S
A
W
al
ways
re
m
ind
ed
a
bout
t
he
im
po
rtance
of
m
ai
ntaining
healt
h,
cl
eanli
ness,
a
nd
it
s
ef
fect
on
t
he
purity
of
one'
s
so
ul.
Ra
s
ul
ullah
SAW
sai
d:
"C
le
an
up
w
hat
y
ou
ar
e
ca
pa
ble
of
because
Alla
h
est
abl
ished
Isl
a
m
above
the
joints
of
cl
ea
nliness.
D
o
no
t
e
nter
heaven
un
le
ss
a
cl
ean
pe
rson".
Ma
intai
nin
g
t
he
cl
eanli
ness
of
the
bo
dy
an
d
it
s
po
ssessi
ons
su
ch
as
cl
oth
i
ng,
ho
us
eh
old
app
li
anc
es,
a
nd
ot
her
obj
ect
s t
hat n
e
ed
to
b
e
k
e
pt cl
ean a
re som
e o
f
the
thin
gs
t
ha
t are
par
t
of a
Muslim
'
s o
blig
at
ion
s
[
10
].
Li
m
it
a
ti
on
s
in
the
proce
ss
of
thi
nk
i
ng
a
re
the
li
m
it
at
ion
s
possess
ed
by
child
ren
with
disa
bili
ti
es,
especial
ly
in
te
rm
s
of
pe
rs
on
a
l
hygiene
re
qu
i
res
at
te
ntio
n
f
r
om
par
ents
i
n
r
ecei
vin
g
in
for
m
at
ion
ab
ou
t
pe
rsonal
hygiene
t
hat
is
associat
ed
with
the
le
vel
of
knowle
dge
pos
sessed
by
childre
n.
Healt
h
e
du
cat
io
n
for
c
hildr
e
n
with
disa
bili
ti
es
can
be
im
pr
ov
e
d
by
te
achi
ng
c
onti
nuousl
y
on
e
of
t
hem
is
by
us
i
ng
a
ud
i
ov
is
ual
m
eth
ods.
The
pro
gress
and
dev
el
op
m
ent
of
sci
ence
an
d
te
ch
no
l
ogy
r
eq
uire
hu
m
ans
to
pass
on
knowle
dge
to
ot
he
r
hu
m
ans.
T
he
a
ud
i
ov
is
ual
m
eth
od
is
one
of
t
he
le
ar
ning
m
e
thods
in
the
f
orm
of
sli
des
co
ntainin
g
pictu
r
es
and
so
un
ds
.
Audi
ovisual
m
edia
has
a
hi
gh
le
vel
of
e
ff
ect
iv
eness,
acc
ordi
ng
t
o
resea
rch,
on
ave
rag
e
abov
e
60% to
80%
[
11
].
The
a
udio
-
vis
ua
l m
e
tho
d was
us
e
d
f
or
the
le
a
rn
i
ng proc
ess i
n
a
utist
ic
ch
il
dren
. T
he
c
ha
ra
ct
erist
ic
s o
f
autist
ic
child
re
n a
re
c
halle
ngi
ng
to
c
omm
un
i
cat
e
an
d t
e
nd
t
o
be
chall
en
ging
t
o c
oncent
rate
on
one
thin
g
t
hat
is
no
t
i
nteresti
ng,
so
the
us
e
of
a
ud
i
o
-
visu
al
m
edia
is
ex
pected
to
at
tract
autist
ic
childre
n'
s
at
te
ntion
an
d
ca
n
f
ollow
the
m
ov
em
ent
s
sho
wn
.
Ba
s
ed
on
pr
e
vious
resea
rch,
a
ud
i
ov
is
ual
le
a
rn
i
ng
m
et
ho
ds
both
pa
rtia
ll
y
an
d
interact
ively
,
s
ign
ific
a
ntly
in
flu
e
nce
t
he
le
arn
i
ng
outc
ome
s
of
c
hild
ren
with
s
pecial
needs
with
a
ut
is
m
,
wh
ic
h
a
re
co
ntr
oll
ed
by
a
ud
i
ov
is
ual
a
nd
ge
nd
e
r
le
arn
i
ng
m
et
ho
ds.
C
hildr
e
n
with
sp
eci
al
needs
,
especial
ly
autist
ic
childre
n
a
re
one
of
the
dis
orde
rs
is
i
n
c
omm
un
ic
at
ing
so
that
they
ne
e
d
t
he
help
of
th
e
m
edia
in
unde
rstan
ding
le
a
rn
i
ng
m
at
e
rial
.
Kno
wled
ge
,
if
done
,
verb
al
ly
will
be
i
ntr
ic
at
e
.
O
ne
of
t
he
m
eans
f
or
le
a
rn
i
ng
in
c
hildr
e
n
is
t
he
m
edia.
C
hildr
e
n
can
be
i
nterested
in
usi
ng
t
he
rig
ht
m
edia.
Lear
ning
s
uccess
occ
urs
i
f
th
ere
is an
interest
in
the lea
rn
i
ng
process
w
it
h t
he
no
te
s
that t
he
i
ns
tr
ucto
r
ca
n
a
dju
st t
o
t
he
i
nterests a
nd c
onditi
ons
of the st
ud
e
nts'
m
edia sel
ect
io
n
[
12
].
No
la
J
.
Pe
nder
is
an
e
xpert
i
n
nursing
t
heory,
a
the
ory
w
hich
he
fou
nd
to
be
ve
ry
pre
ci
se
with
this
researc
h
to
pic.
Pe
nder
intr
od
uces
nu
rsing
theo
ry:
Nursin
g
Prom
otion
Mod
el
or
Hea
lt
h
P
ro
m
otion
Mo
del
(H
PM
).
The
ap
plica
ti
on
i
n
HPM
fo
c
us
es
on
a
ssessm
ent
factor
s
that
a
re
belie
ved
to
be
a
ble
to
in
fl
ue
nce
c
ha
ng
e
s
in
healt
h
be
ha
vi
or
.
Be
ha
vi
or
that
prom
otes
he
al
th
is
t
he
en
dpoi
nt
or
form
s
of
act
io
n
t
hat
le
ad
t
o
the
achie
vem
ent
of
posit
ive h
ea
lt
h
su
c
h
as opti
m
al
w
el
l
-
being, p
er
sonal
fulfi
llm
ent, an
d
pr
oductive li
fe
. F
a
m
ilies wit
h
chi
ldre
n
who
ha
ve
disa
bi
li
ti
es
need
he
al
th
effo
rts,
one
of
w
hic
h
is
t
o
pay
at
te
ntio
n
to
how
far
chi
ldre
n
ca
n
rec
ei
ve
a
nd
unde
rstan
d an
d p
racti
ce
perso
nal
hygie
ne. T
he
aim
is to as
s
ess th
e
be
hav
i
or
(level
of
kn
owle
dge,
att
it
ude) a
nd
childre
n
with
disabili
ti
es
relat
ed
to
per
s
onal
h
ygie
ne
[
12
]
.
E
xce
ptio
n
al
ed
ucati
on,
exer
ci
ses
,
pr
ov
i
ding
exp
e
rienc
e
,
a
nd
s
kill
s
about
daily
li
fe
are
so
m
e
of
the
e
ffor
ts
i
n
re
duc
ing
de
pende
nc
y
and
li
m
it
a
tio
ns
in
sel
f
-
care
[4
]
.
Kno
wled
ge
an
d
sk
il
ls
ca
n
be
pr
ov
i
ded
i
n
the
form
of
he
al
th
e
du
cat
io
n.
Healt
h
e
duc
at
ion
is
the pr
ocess of
m
aking
pe
op
le
ab
le
to
im
pr
ove an
d
im
pr
ove
healt
h,
e
sp
eci
a
ll
y chil
dr
en
w
it
h disabil
it
ie
s
[
13
].
The
res
ults
of
a
prel
i
m
inary
stud
y
c
onduct
e
d
at
Ba
ntu
l
1
S
pecial
Sc
hool
and
ba
sed
on
t
he
resu
lt
s
of
intervie
ws/info
rm
ation
obta
in
ed
from
pa
ren
t
s
of
stu
de
nts
is
that
their
c
hild
ren
sti
ll
feel
ca
pab
le
of
car
ryi
ng
ou
t
so
m
e
per
s
onal
hy
giene
act
iv
it
ie
s
,
but
s
ome
tim
es
their
a
bili
ti
es
are
no
t
in
li
ne
with
the
resu
lt
s
obt
ai
ned
.
Fo
r
e
xam
ple,
if
t
he
c
hild
ent
ers
t
he
bat
hro
om
,
he
will
s
pe
nd
a
lo
ng
ti
m
e
in
t
he
b
at
hro
om
,
about
1
hour
,
and
w
he
n
he
has
finis
hed
ba
thing
s
om
eti
m
es
there
is
sti
ll
so
ap
or
no
brus
hing
s
o
t
ha
t
it
even
sm
e
ll
s
bad.
The
pa
ren
ts
of
the
st
udents,
i
n
t
his
case
the
m
oth
er
sai
d
t
hat
if
bat
hing
or
bru
sh
i
ng
th
ei
r
te
et
h
is
not
cl
ean,
the
c
hild
wi
ll
be
ta
ken
ba
ck
to
t
he
bath
room
and
a
ssist
ed
by
his
m
oth
er
to
cl
ean
it
opti
m
a
ll
y.
Based
on
the
bac
kgr
ound
an
d
e
xperien
ce
ab
ov
e
,
the
r
esearche
r
is
int
erested
i
n
exa
m
ining
the
e
ffec
t
of
healt
h
e
du
cat
i
on
on
pe
rs
on
al
hy
giene
with
a
ud
i
ov
is
ual
m
eth
ods
on
the
b
ehav
i
or
a
nd
s
el
f
-
ef
ficacy
of
perso
nal
hy
giene
in
m
ental
ly
disabl
ed
c
hildr
e
n
.
Evaluation Warning : The document was created with Spire.PDF for Python.
In
t.
J.
Publi
c He
al
th Sci.
IS
S
N: 22
52
-
8806
Hea
lt
h ed
uc
ation i
m
pr
ov
e
be
ha
vi
or
and sel
f
-
ef
f
ic
acy on pe
rsona
l
hy
giene
amon
g… (
Tit
ie
k H
id
ay
ati
)
393
2.
RESEA
R
CH MET
HO
D
The
desi
gn
of
t
his
st
ud
y
is
a
quantit
at
ive
a
pp
ro
ac
h
us
i
ng
a
n
exp
e
rim
ental
de
sign
:
pre
-
e
xpe
rim
ent
with
the
desig
n
of
t
he
pr
et
est
-
post
te
st
gro
up
design.
Re
s
ponde
nt
s
will
be
giv
e
n
a
pret
est
firs
t
;
after
t
hat
,
t
he
y
are
giv
e
n
t
reatm
ent
an
d
after
the
proce
dure
will
be
giv
e
n
a
po
stt
est
[
14
]
.
Th
e
inter
ve
ntion
gro
up
in
this
s
tud
y
i
s
healt
h
e
ducat
io
n
us
in
g
au
diovi
su
al
m
et
ho
ds
a
bout
perso
nal
hy
giene.
T
he
popu
la
ti
on
i
n
t
his
stud
y
we
re
c
hildr
e
n
with
intel
le
ct
ua
l
disabili
ty
.
The
sam
ple
in
this
stu
dy
wer
e
30
c
hildre
n
w
it
h
intel
le
ct
ual
disabili
t
ie
s
at
sch
oo
l
age.
The
re
we
re
th
ree
s
pecia
l
schools
i
nclu
ded
in
t
his
stu
dy,
al
l
locat
ed
in
S
pecial
Re
gion
of
Y
og
ya
kar
ta
,
Ind
on
esi
a.
T
he
tech
nique
us
e
d
i
n
this
r
es
ear
ch
is
takin
g i
s t
otal sam
pling
.
The p
ro
t
oco
l
has bee
n re
view
ed
a
nd
appr
ov
e
d
by
t
he
et
hics
c
omm
i
tt
ee
of
the
Fac
ul
ty
of
Me
dicine
an
d
Healt
h
Sci
ences,
Mu
ham
m
adiy
ah
U
niv
e
rsity
of Yog
ya
kar
ta
,
n
o
et
hical
clea
ran
ce
let
te
r: 03
3
/
EP
-
FKIK
-
UMY
/II/
2019.
The
inst
ru
m
ent
in
this
stu
dy
was
te
ste
d
for
validit
y
us
in
g
t
he
pr
oduct
-
m
ome
nt
correla
ti
on
te
ch
nique
us
in
g Alp
ha
Cr
onbac
h
(α
) wit
h
a si
gn
i
ficanc
e level
of
95%.
Rel
ia
bili
ty
tes
t
u
sin
g
t
he
Cr
on
bach Al
ph
a
m
e
thod
with
de
gr
ees
of
fr
ee
do
m
(
df)
=(n
-
2)
a
nd
α
=
0.0
5
t
hen
if
r
ari
thm
e
ti
c>
r
ta
bl
e,
qu
est
i
on
s/st
a
te
m
ents
are
de
cl
ared
reli
able or
r
a
ri
thm
e
ti
c
≤r
table
s,
quest
io
ns are
d
ecl
are
d u
nr
el
ia
ble.
The
prere
quisi
te
te
st
is
con
duct
ed
to
fin
d
ou
t
wh
et
her
pa
ram
et
ric
data
can
be
m
et
or
not
[
15
]
.
Hyp
oth
esi
s
te
sti
ng
of
this
st
ud
y
to
pro
ve
the
e
ff
ect
ive
ne
ss
of
healt
h
e
du
cat
io
n
on
pe
rsonal
hygie
ne
wit
h
aud
i
ov
is
ual
m
et
hods
on
t
he
be
hav
i
or
a
nd
sel
f
-
e
ff
ic
acy
of
pe
rsonal
hygie
ne
in
intel
le
ct
ua
ll
y
disabled
c
hi
ldren,
was
a
naly
zed
us
in
g
Paire
d
T
-
te
st
te
st
sta
ti
sti
cs
if
the
data
wer
e
no
rm
ally
distri
bu
te
d
a
n
d
if
the
data
w
ere
no
t
norm
al
l
y
distribu
te
d
the
hy
pothesis
te
st
us
e
d
te
st
W
il
co
xon
sign
e
d
ranks
te
st
pr
e
viously
c
onduct
ed
a
nor
m
al
i
ty
te
st usin
g
S
ha
pi
ro
Wilk
with a
sam
ple less than 50
.
3.
RESU
LT
S
AND DI
SCUS
S
ION
S
3.1.
Charac
teristic
s of rese
arch
s
ubj
ec
ts
Data
f
r
om
a
total
of
30
c
hildr
e
n
were
ta
ke
n
from
three
sp
eci
al
sc
hool
s
in
t
he
Sp
eci
al
Re
gion
of
Yogyaka
rta.
T
he
c
har
act
erist
i
cs
of
resea
rc
h
s
ubj
ect
s
a
re
s
hown
i
n
T
a
ble
1.
Ba
sed
on
T
abl
e
1,
m
os
t
res
pond
e
nts
wer
e
m
al
e
and
in
the
a
ge
gro
up
of
7
-
12
ye
ars
ol
d.
The
re
wa
s
no
fem
al
e
resp
on
den
t
in
Teg
ar
Har
a
pa
n
Sc
hool
.
Ba
sed
on
intel
le
ct
ual
disabili
ty
ty
pe,
al
l
res
pondents
in
T
e
gar
Ha
rap
a
n
a
nd
Mu
ham
m
a
diya
h
Sc
hool
wer
e
in
m
il
d
ty
pe,
whil
e all
r
esp
onde
nt
s in
Ba
ng
un P
utra
sc
hool
we
re in m
ediu
m
t
ype.
Table
1.
Re
s
po
nd
e
nts’ cha
ract
erist
ic
s b
y t
he
sch
oo
l
(
n
=
30)
Variables
Ban
g
u
n
Putra
Sch
o
o
l
Tegar
H
arapan
Sc
h
o
o
l
Muh
a
m
m
ad
i
y
ah
S
ch
o
o
l
n
(%)
n
(%)
n
(
%)
Gen
d
er
Fe
m
ale
Male
Ag
e gro
u
p
3
(
3
0
)
0
(
0
)
6
(
4
6
.
1)
7
(
7
0
)
7
(
1
0
0
)
7
(
5
3
.
9)
7
-
12
1
0
(
1
0
0
)
7
(
1
0
0
)
10
(76
.
9)
13
-
15
0
(
0
)
0
(
0
)
3
(
2
3
.
1)
Intellectu
al dis
ab
il
ity
t
y
p
e
Mild
0
(
0
)
7
(
1
0
0
)
1
3
(
1
0
0
)
Mediu
m
1
0
(
1
0
0
)
0
(
0
)
0
(
0
)
Paternal edu
catio
n
Ju
n
io
r
h
ig
h
sch
o
o
l
2
(
2
0
)
0
(
0
)
1
(
7
.
7)
Hig
h
sch
o
o
l
8
(
8
0
)
5
(
7
1
,4)
1
1
(
8
4
.
6)
Bach
elo
r’
s d
eg
ree
0
(
0
)
2
(28
,6)
1
(
7
.
7)
Paternal o
ccup
atio
n
Ho
u
sewiv
es
1
0
(
1
0
)
5
(
7
1
,4)
1
2
(
9
2
.
3)
Private e
m
p
lo
y
ees
0
(
0
)
2
(
2
8
,6)
1
(
7
.
7)
Paternal in
co
m
e
Less th
an
m
in
i
m
u
m
w
ag
e
1
0
(
1
0
)
5
(
7
1
,4)
1
2
(
9
2
.
3)
Mini
m
u
m
wag
e
0
(
0
)
2
(
2
8
,6)
1
(
7
.
7)
So
u
rce
:
Pri
m
ar
y
D
ata
,
2
0
1
9
The
highest
nu
m
ber
of
res
po
ndents
base
d
on
pater
nal
ed
uca
ti
on
we
re
in
t
he
high
sc
hool
c
at
egory,
in
al
l
school.
None
of
t
he
res
po
nd
e
nts
in
Teg
a
r
Ha
ra
pan
School
ha
d
pa
re
nts
with
jun
i
or
hi
gh
sc
hool
e
du
cat
ion
,
and
none
in
B
angu
n
P
utra
S
chool
ha
d
pa
r
ents
wit
h
bachel
or
’
s
de
gr
ee
s
.
Most
r
esp
onde
nts
ha
d
ho
use
wife
m
oth
ers
an
d pa
ren
ta
l i
nc
om
e o
f
less tha
n reg
ion
al
m
ini
m
u
m
w
a
ge
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SSN
:
2252
-
88
06
In
t.
J.
Publi
c He
al
th Sci. V
ol.
8
,
No.
4
,
Dece
m
ber
201
9
:
39
1
–
3
99
394
3.2. Pre
-
post
-
test on kn
owle
dg
e,
att
i
tu
de
, beha
vio
r
,
an
d
sel
f
-
ef
ficac
y o
n p
ers
onal h
ygie
ne
The
m
ean
val
ue
of
kn
ow
le
dg
e,
at
ti
tud
e,
pra
c
ti
ce
,
and
sel
f
-
eff
ic
acy
be
f
or
e
an
d
afte
r
healt
h
e
du
cat
io
n
was
s
how
n
i
n
T
able
2,
w
hile
the
cha
nges
i
n
cat
egory
f
or
ea
ch
var
ia
ble
be
f
or
e
an
d
a
fter
he
al
th
ed
ucati
on
was
sh
ow
n
i
n
T
abl
e
3.
The
m
ean
val
ue
f
or
eac
h
va
riable
inc
re
ased
sig
nifican
tl
y
af
te
r
t
he
e
duca
ti
on,
as
s
ho
wn
in
T
able
2.
T
he
h
i
gh
e
st i
ncr
ea
se
is o
n
the
b
e
ha
vi
or
var
ia
ble,
wi
th an inc
rease
of 1.8
3.
Tab
le
2.
Score
s
of
knowle
dge
, atti
tud
es,
b
e
ha
viors, a
nd self
-
ef
ficacy
on
pe
rsonal
hygiene
befor
e
and a
fte
r
healt
h
e
ducat
io
n (n
=
30)
Variables
Measu
re
m
en
t
Mini
m
u
m
-
M
ax
i
m
u
m
Mean±SD
Kn
o
wled
g
e
Pretest
2
.00
-
8
.00
6
.03
±1
.51
Po
sttes
t
5
.00
-
8
.00
7
.06
±0
.82
Attitu
d
e
Pretest
5
.00
-
1
6
.00
1
1
.56
±2
.8
6
Po
sttes
t
8
.00
-
1
6
.00
1
2
.26
±1
.5
2
Beh
av
io
r
Pretest
8
.00
-
1
4
.00
1
1
.73
±1
.7
0
Po
sttes
t
1
0
.00
-
4
5
.0
0
1
3
.56
±6
.8
6
Self
-
ef
f
icacy
Pretest
0
.00
-
3
.00
1
.93
±0
.86
Po
sttes
t
0
.00
-
3
.00
2
.10
±0
.88
So
u
rce:
Pri
m
ar
y
D
ata,
2
0
19
Tabl
e
3.
K
now
le
dg
e,
att
it
ud
e,
b
e
hav
i
or
,
a
nd
sel
f
-
ef
ficacy
on
per
s
onal
h
y
gi
ene b
e
f
or
e
an
d
after
healt
h
E
ducat
ion
(
n=
30
)
Variables
Pretest
Pos
ttest
n
(%)
n
(%)
Kn
o
wled
g
e
Po
o
r
Su
f
f
icien
t
Go
o
d
6
(
2
0
)
1
3
(
4
3
.3)
1
1
(
3
6
.7)
1
(
3
.3)
6
(
2
0
)
2
3
(
7
6
.7)
Attitu
d
e
Po
o
r
Su
f
f
icien
t
Go
o
d
2
5
(
8
3
.3)
1
(
3
.3)
4
(
1
3
.3)
2
9
(
9
6
.7)
0
(
0
)
1
(
3
.3)
Beh
av
io
r
Did
no
t practiced
Practiced
8
(
2
6
.7)
2
2
(
7
3
.3)
3
(
1
0
)
2
7
(
9
0
)
Self
-
ef
f
icacy
Low
Hig
h
2
1
(
7
0
)
9
(
3
0
)
1
8
(
6
0
)
1
2
(
4
0
)
Total
3
0
(
1
0
0
)
3
0
(
1
0
0
)
So
u
rce:
Pri
m
ar
y
D
ata,
2
0
19
Table
3
s
how
s
that
t
her
e
was
a
n
increa
se
in
kn
ow
le
dg
e
afte
r
bein
g
giv
e
n
healt
h
e
ducat
ion,
from
su
ff
ic
ie
nt
cat
ego
ry
to
t
he
prop
e
r
cat
eg
or
y.
T
her
e
wa
s
no
dif
fer
e
nce
in
at
ti
tud
e
befor
e
a
nd
a
fter
he
al
th
edu
cat
io
n,
bu
t
ther
e
was
an
increase
in
pra
ct
ic
ed
cat
eg
ory
for
be
ha
vio
r
va
riable
an
d
i
n
high
cat
eg
ory
f
or
sel
f
-
ef
ficacy
varia
ble.
Me
a
nwhile
, k
nowle
dg
e
of
perso
na
l hygiene
are
presente
d
in
Ta
ble 4.
Table
4.
K
now
le
dg
e
of
per
s
onal
h
y
giene be
fore a
nd after
hea
lt
h
ed
ucati
on
b
y sc
hool
(n
=
30)
Sch
o
o
l
Kn
o
wled
g
e
Pretest
Pos
ttest
n
(%)
n
(%)
Ban
g
u
n
Putra
Po
o
r
Su
f
f
icien
t
Go
o
d
1
(
1
0
)
5
(
5
0
)
4
(
4
0
)
0
(
0
)
2
(
2
0
)
8
(
8
0
)
Tegar
H
arapan
Po
o
r
Su
f
f
icien
t
Go
o
d
1
(
1
4
.3)
3
(
4
2
.9)
3
(
4
2
.9)
1
(
1
4
.3)
1
(
1
4
.3)
5
(
7
1
.4)
Muh
a
m
m
ad
i
y
ah
Po
o
r
Su
f
f
icien
t
Go
o
d
4
(
3
0
.8)
5
(
3
8
.5)
4
(
3
0
.8)
0
(
0
)
3
(
2
3
.1)
1
0
(
7
6
.9)
Total
3
0
(
1
0
0
)
3
0
(
1
0
0
)
So
u
rce:
Pri
m
ar
y
D
ata,
2
0
1
9
Ba
sed
on
T
a
bl
e
4,
M
uh
am
m
a
diya
h
Scho
ol
e
xp
e
rience
d
m
ost
cha
ng
e
s
in
t
he
knowle
dge,
as
they
ha
d
the
highest
i
nc
rease
i
n
c
hild
re
n
with
go
od
know
le
dg
e
a
fter
healt
h
e
ducat
io
n.
O
ne
of
t
he
f
act
or
s
that
i
nf
l
uen
ce
knowle
dge
is
the
a
ge
facto
r
of
w
hich
the
m
ajo
rity
of
res
pondents
we
re
in
t
he
7
-
12
y
ears
a
ge
ra
ng
e
of
27
respo
nd
e
nts
wi
th
eac
h
sp
eci
al
sc
hool;
Ba
ng
un
Pu
t
ra
Scho
ol
ha
s
te
n
res
pond
e
nts,
Te
gar
Har
a
pa
n
Scho
ol
has
Evaluation Warning : The document was created with Spire.PDF for Python.
In
t.
J.
Publi
c He
al
th Sci.
IS
S
N: 22
52
-
8806
Hea
lt
h ed
uc
ation i
m
pr
ov
e
be
ha
vi
or
and sel
f
-
ef
f
ic
acy on pe
rsona
l
hy
giene
amon
g… (
Tit
ie
k H
id
ay
ati
)
395
seve
n
re
spo
ndents,
a
nd
Mu
ham
m
adiy
ah
School
13
res
po
nd
e
nts.
Chil
dr
en
with
intel
le
ct
ual
disa
bili
ties
at
the
age
of
7
-
12
ye
ars
a
re
n
ot
ye
t
m
a
ture
to
receive
a
ny
in
form
ation
.
Know
le
dg
e
a
bout
per
s
onal
hygi
ene
in
m
ental
ly
disabl
ed
child
ren
is
on
ly
obta
ine
d
from
exp
erience
an
d
in
for
m
at
ion
from
par
ents
a
nd
te
a
cher
s
.
Howe
ver,
heal
th
ed
ucati
on
a
bout
per
s
onal
hygiene
has
ne
ver
bee
n
done
by
ot
h
er
par
ti
e
s
outsi
de
the
s
chool
.
Healt
h
e
ducat
ion i
s t
he rig
ht
appr
oach to
in
crease
healt
h k
nowled
ge
b
eca
us
e
healt
h ed
uc
at
ion
is
m
or
e
fo
c
us
e
d
on pre
ven
ti
on
effor
ts
[
4
,
1
4
]
.
Healt
h
e
du
cat
i
on
i
n
this
st
udy
us
es
t
he
au
di
o
-
vis
ual
m
et
ho
d
by
watc
hing
vid
eo
s
co
ntainin
g
s
ound
an
d
m
ov
e
m
ent
in
pr
act
ic
in
g
per
s
on
al
hygie
ne
a
ct
ivit
ie
s.
This
i
s
in
li
ne
with
pr
e
vious
resea
rch
,
w
hich
sta
te
s
that
vid
e
o
m
edia
is
us
e
d
to
facil
it
at
e
res
pondents
in
r
ecei
ving
i
nfor
m
at
ion
subm
it
te
d
by
rese
arc
her
s
[
9
]
.
T
he
re
su
lt
s
of
pr
e
vious
stu
dies,
n
am
el
y
[
1
]
the
us
e
of to
r
so m
edia can
im
pr
ov
e
the
ab
i
li
ty
o
f
te
ac
hers
to
car
ry
out l
e
arn
i
ng
in
the
first
cy
cl
e
an
ave
ra
ge
of
2.8
an
d
a
per
c
entage
of
70%.
In
c
rease
in
th
e
second
cy
cl
e
a
n
ave
ra
ge
of
3.
8
an
d
a
pe
rce
ntage
of
95
%
.
[
2
]
The
us
e
of
to
rso
m
edia
in
le
arn
in
g
c
an
i
m
pr
ov
e
stu
de
nt
le
ar
ning
ou
tc
om
es,
nam
ely
cy
cl
e
I
,
the
total
num
ber
of
stu
den
t
scor
e
s
by
200
,
and
a
n
a
ve
rag
e
val
ue
of
66.67
inc
reased
in
c
yc
le
II
by
240
a
nd
an
aver
a
ge
value
of
80.
T
or
s
o
m
edia
can
gro
up
into
vis
ual
m
edia.
Visu
al
m
edia
are
m
edia
that
on
ly
rely
on
the
se
nse
of
si
gh
t.
T
his
vis
ual
m
edia
disp
la
ys
sti
ll
im
ages
suc
h
as
fil
m
strips,
phot
o
sli
des
,
pictu
res
or
paintin
gs
,
an
d
pr
i
nts.
T
he
re
a
r
e
al
so
vis
ual
m
edia
that
show
m
ov
ing
im
ages
or
sym
bo
ls
s
uc
h
as
sil
ent
film
s
and
carto
on f
il
m
s
[
16
,
17
]
.
Pers
on
al
m
enstru
al
hy
giene
beh
a
vior
is
le
s
s
infl
uen
ce
d
by
knowle
dge
[
9
]
.
E
du
cat
io
n
is
the
m
os
t
crit
ic
al
do
m
ain
f
or
t
he
f
or
m
at
ion
of
one
'
s
act
ion
s.
Be
hav
i
or
ca
n
be
change
d
by
pro
vid
in
g
in
form
ation
.
So
m
eon
e
w
ho
has
m
or
e
sourc
es of i
nfor
m
at
i
on
will
h
av
e m
or
e
kn
ow
le
dg
e
as
well
[
14
]
.
B
ased
on T
a
ble
4
t
ha
t
an
i
ncr
ease
in
knowle
dge
af
te
r
bei
ng
giv
e
n
healt
h
e
duca
ti
on
.
The
n
it
be
ca
m
e
cl
ear
th
at
when
the
m
ental
retard
at
i
on
know
le
dg
e
of
23
respo
nd
e
nts
oc
curred
,
it
would
a
uto
m
at
ic
a
ll
y
aff
ect
per
s
on
al
hygiene
be
hav
i
or
with
t
he
help
of
in
div
i
du
al
hy
giene
co
ntr
ol
s
heets
that
we
re
fill
ed
e
ve
ry
da
y
for
2
wee
ks.
H
ence
,
at
ti
tu
de
on
per
s
onal
h
y
giene
a
re showe
d i
n
Ta
ble 5.
Table
5.
Atti
tud
e
on p
e
rs
on
al
hygiene
b
e
f
or
e
and a
fter
healt
h
e
du
cat
io
n by
the sc
hool
(
n=
30)
Sch
o
o
l
Attitu
d
e
Pretest
Po
sttes
t
n
(
%)
n
(
%)
Ban
g
u
n
Putra
Po
o
r
8
(
8
0
)
9
(
9
0
)
Su
f
f
icien
t
1
(
1
0
)
0
(
0
)
Go
o
d
1
(
1
0
)
1
(
1
0
)
Tegar
H
arapan
Po
o
r
5
(
7
1
,4)
Su
f
f
icien
t
0
(0)
7
(
1
0
0
)
Go
o
d
2
(
2
8
.
6)
0
(
0
)
Muh
a
m
m
ad
i
y
ah
Po
o
r
1
2
(
9
2
.
3)
0
(
0
)
Su
f
f
icien
t
0
(
0
)
1
3
(
1
0
0
)
Go
o
d
1
(
7
.
7)
0
(
0
)
Total
3
0
(
1
0
0
)
0
(
0
)
So
u
rce:
Pri
m
ar
y
D
ata,
2
0
19
Ba
sed
on
t
he
r
esults
of
the
m
easur
em
ent
of
at
ti
tud
es
in
T
a
ble
5,
the
re
we
re
no
posit
ive
changes
in
childre
n
with
intel
le
ct
ual
dis
abili
ty
after
he
al
th
ed
ucati
on.
The
resu
lt
s
of
t
he
at
ti
tude
cat
eg
or
y
di
d
not
exp
e
rience
a
diff
e
ren
c
e
in
ei
th
er
the
pre
-
te
st
or
post
-
te
st
cat
egories
with
fe
wer
cat
eg
or
ie
s.
Pers
onal
hy
giene
i
s
influ
e
nce
d
by
var
i
ou
s
fact
ors
su
c
h
as
s
ociet
y,
fam
il
y
and
i
nd
i
vidual
a
wareness
an
d
at
ti
t
ud
e
s
a
bout
cl
e
anliness.
Most
healt
h
pr
ob
le
m
s
aff
ect
ing
sch
ool
stu
de
nts
can
be
pre
ven
te
d
by
pro
m
ot
ing
good
hy
giene
pr
act
ic
e
s
thr
ough
fam
i
li
es and
a
doptin
g g
ood he
al
th
ed
ucati
on
[
18
]
.
Table
6
sho
ws
that
t
he
sch
oo
l
that
e
xperien
ced
m
os
t
c
hanges
was
Te
gar
Ha
ra
pan
Sc
ho
ol,
with
al
l
childre
n
pr
act
i
ced
per
s
onal
hy
giene
beh
a
vior
afte
r
healt
h
e
du
cat
io
n.
Be
ha
vioral
cat
eg
or
i
es
cha
nge
bu
t
are
not
sign
ific
a
nt.
T
he
resu
lt
s
of
th
e
act
ion
of
re
sp
on
de
nts’
pre
te
st
and
po
stt
est
are
in
the
pr
act
ic
ed
cat
egory.
Chil
dr
e
n
with
intel
le
ct
ual
dis
abili
ti
es
need
help
f
ro
m
othe
rs
in
m
eet
ing
their
nee
ds
.
P
aren
ta
l
assist
a
nce
is
requir
e
d
to
e
nc
oura
ge
ada
ptiv
e
be
hav
i
or
i
n
m
ental
ly
disabl
ed
c
hildr
e
n
[
19
]
.
The
li
nk
between
healt
h
e
ducat
io
n
with
m
ental
ret
ard
at
io
n
beh
a
vi
or
is
that
they
will
su
pp
or
t
ea
ch
ot
her
i
f
pa
r
ents
enc
oura
ge
and
sup
port
m
ental
retard
at
i
on acti
viti
es, esp
eci
al
ly
in
f
ulfill
ing
per
s
onal
h
y
giene
act
ivit
ie
s.
Pare
nting
that
is
owne
d
by
pa
ren
ts
in
te
rm
s
of
qual
it
y
an
d
intensit
y
of
t
he
at
te
ntio
n
giv
e
n
by
pa
ren
ts
will
aff
ect
the
at
ti
tud
es
an
d
be
hav
i
or
of
c
hildr
e
n.
So
m
e
fac
tors
t
hat
in
flue
nce
par
e
ntin
g
i
nclu
des
e
ducat
ion
al
backg
rou
nd,
oc
cup
at
io
n,
a
nd
so
ci
oec
onom
ic co
ndit
ion
s
[
20
]
.
P
rev
i
ous
st
udy
co
nducted
on
sch
ool
-
a
ge c
hi
ldre
n
who
are
not
di
sabled
s
hows
that
durin
g
the
6
m
o
nth
s
the
interve
ntio
n,
t
her
e
was
a
sig
nificant
inc
rea
se
in
the
le
vel
of
kn
ow
le
dg
e
,
at
ti
tu
des,
an
d
pr
a
ct
ic
es
in
sc
hools
and
co
ntin
uing
healt
h
ed
ucati
on
pr
ogram
s
about
per
s
onal
hygie
ne
with
the
involvem
ent
of
pa
ren
ts/
gu
a
r
di
ans
of
stu
de
nt
s
will
ha
ve
a
great
e
r
im
pa
ct
on
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SSN
:
2252
-
88
06
In
t.
J.
Publi
c He
al
th Sci. V
ol.
8
,
No.
4
,
Dece
m
ber
201
9
:
39
1
–
3
99
396
a
sig
nificant
in
crease
i
n
t
he
le
vel
of
kn
ow
le
dge,
at
ti
tud
es
an
d
pr
act
ic
es
of
s
tud
e
nts
a
bout
pe
rsonal
hygie
ne
[
21
]
.
The researc
h c
an be a
ref
e
re
nc
e m
a
te
rial
f
or
furthe
r
re
searc
h
s
o
t
hat the e
xpect
ed res
ults
can
be
si
gn
ific
ant.
Table
6.
Be
ha
vi
or
on
per
s
onal
h
ygie
ne bef
ore an
d
a
fter
heal
th educat
io
n b
y t
he
sc
hool (n
=30)
Sch
o
o
l
Beh
av
io
r
Pretest
Pos
ttest
n
(%)
n
(%)
Ban
g
u
n
Putra
Did
no
t practiced
Practiced
1
(
1
0
)
9
(
9
0
)
0
(
0
)
1
0
(
1
0
0
)
Tegar
H
arapan
Did
no
t practiced
Practiced
3
(
4
2
.9)
4
(
5
7
.1)
0
(
0
)
7
(
1
0
0
)
Muh
a
m
m
ad
i
y
ah
Did
no
t practiced
Practiced
4
(30
.8)
9
(
6
9
.2)
3
(
2
3
.1)
1
0
(
7
6
.9)
Total
3
0
(
1
0
0
)
3
0
(
1
0
0
)
So
u
rce:
Pri
m
ar
y
D
ata,
2
0
19
Othe
r resea
rc
h
exp
la
in
s
that
m
ental
ly
disabl
e
d chil
dr
e
n
have
intel
li
gen
ce
be
low t
he a
ve
ra
ge w
ho
will
exp
e
rience
ba
r
riers
t
o
thei
r
adap
ti
ve
beh
a
vior,
t
hu
s
re
quirin
g
t
he
help
of
ot
her
s
in
m
ee
ti
ng
their
nee
ds.
The
resu
lt
s
of
his
resea
rc
h
on
"t
he
e
ff
ect
of
healt
h
ed
ucat
ion
with
dem
on
strat
io
n
m
et
ho
ds
on
hand
w
ashin
g
beh
a
vior
in
m
ental
ly
retard
e
d
childre
n"
sho
w
s
that
t
he
m
et
ho
d
of
ha
ndwa
s
hing
dem
on
str
at
ion
help
s
m
ental
l
y
retard
e
d
chil
dren
t
o
t
hink
s
o
that
child
re
n
ge
t
involve
d,
th
ing
s
that
ha
ve
been
see
n
ser
ve
as
e
xam
ples
to
be
pr
act
ic
ed
w
it
h
gu
i
ded pract
i
ce an
d
im
pr
ove
hi
s b
e
hav
i
or
i
n dail
y l
ife as e
xpect
ed
[
22
]
.
The
resu
lt
s
of
the
per
s
onal
hy
giene
c
ontr
ol
s
heet
car
ried
ou
t
for
two
weeks
sho
wed
t
hat
the
m
ajo
rity
of
own
hy
giene
act
ivit
ie
s
e
xp
e
rience
d
i
nc
rease
d
inact
ivi
ty
.
Seve
ral
ch
il
dr
en
ha
d
we
ll
per
s
on
al
hy
giene
s
(
30
res
ponde
nts
)
(
100%
).
T
hi
s
is
con
sist
e
nt
with
previ
ous
r
esearch
t
hat
th
ere
is
the
ef
fec
t
of
healt
h
e
du
cat
ion
on
m
enstru
al
c
are
on
m
enstrual
perso
nal
hygi
ene
beh
a
vior
i
n
a
dole
scent
gi
rls
wit
h
m
ental
retar
datio
n
i
n
Ba
ntu
l
1
S
pecial
Sc
hool
[
9
]
.
T
able
7
rev
eal
s
that
sc
hool
with
m
os
t
cha
ng
e
s
in
sel
f
-
ef
f
ic
acy
was
Ba
ngun
Pu
t
ra
Sc
hool
,
wit
h
tw
o
childre
n
m
ana
ged
to
inc
reas
e
their
sel
f
-
ef
ficacy
from
low
to
the
hi
gh
cat
e
gory
a
fter
healt
h
e
duc
at
ion
.
Chil
dr
e
n
with
autist
ic
disabil
it
ie
s,
who
a
re
al
read
y
in
de
pe
nd
e
nt,
are
not
accom
pan
ie
d
by
pa
re
nts
a
nd
a
re
order
e
d
by
pa
r
ents
t
o
be
able
to
car
ry
ou
t
st
ages
of
pe
rson
al
hygie
ne
a
ct
ivit
ie
s
su
c
h
as
brus
hing
t
heir
te
et
h,
wash
i
ng
t
heir
ha
nds,
was
hi
ng
t
heir
hai
r,
com
bin
g
their
hair,
a
nd
t
oilet
trai
ning.
T
his
s
how
s
t
hat
a
utist
ic
chil
dre
n
who
are
in
de
pe
nd
e
nt
do
not
ha
ve
doubts
an
d
can
be
m
or
e
re
sp
onsi
ble
for
t
hem
sel
ves
[
8
]
.
Wh
e
n
co
rr
el
at
e
d
with
the
resu
lt
s
of
s
el
f
-
ef
ficacy
in
T
able
3,
it
ca
n
be
c
oncl
ude
d
t
hat
t
he
sel
f
-
e
ffi
cacy
of
m
ental
ly
disabl
ed
c
hi
ldren
will
b
e
high if
the ch
il
d i
s a
ble and c
onfide
nt
to
car
ry out
pe
rsonal
hygien
e act
ivit
ie
s independe
ntly
.
Tab
le
7.
Self
-
e
ff
ic
acy
on pe
rs
on
al
hygie
ne b
efore a
nd afte
r heal
th e
ducat
io
n
by the
sch
ool
(
n=30)
Sch
o
o
l
Self
-
ef
f
icacy
Pretest
Pos
ttest
F
(%
)
F
(%
)
Ban
g
u
n
Putra
Low
Hig
h
8
(
8
0
)
2
(
2
0
)
6
(
6
0
)
4
(
4
0
)
Tegar
H
arapan
Low
Hig
h
4
(
5
7
.
1)
3
(
4
2
.
9)
4
(
5
7
.
1)
3
(
4
2
.
9)
Muh
a
m
m
ad
i
y
ah
Low
Hig
h
9
(
6
9
.
2)
4
(
3
0
.
8)
8
(
6
1
.
5)
5
(
3
8
.
5)
Total
3
0
(
1
0
0
)
3
0
(
1
0
0
)
So
u
rce:
Pri
m
ar
y
D
ata,
2
0
19
Fact
or
s
that
re
qu
i
re
at
te
ntio
n
in
inc
reasin
g
sel
f
-
ef
ficacy
of
stu
de
nts
with
sp
eci
al
nee
ds
in
inclusi
ve
sch
oo
ls
a
re
t
he
avail
abili
ty
of
assessm
ent
spa
ce,
the
a
vaila
bili
ty
of
te
ache
rs
who
as
sist
s
tud
e
nts
in
div
i
du
al
ly
,
the
m
anag
em
e
nt
of
inclusi
ve
cl
ass
syst
e
m
s
,
an
d
the
s
kill
s
of
cl
ass
room
te
achers
in
guidin
g
a
nd
dir
ect
ing
stud
e
nts
with
sp
eci
al
need
s
to
op
ti
m
iz
e
it
s
pote
ntial
.
Thi
s
s
hows
that
s
el
f
-
ef
ficacy
in
car
ryi
ng
ou
t
daily
act
ivit
ie
s,
espe
ci
al
ly
per
s
on
al
hy
giene
requi
res
t
he
s
kill
s
of
people
w
ho
pr
ov
i
de
he
al
t
h
ed
ucati
on
so
that
the potenti
al
of the c
hild is
op
tim
a
l and is ap
plied at
ho
m
e
[
23
]
.
3.3. H
ypothes
is prere
quisi
te
t
es
t
The
n
orm
ality
te
st
was
done
as
hypothesis
pr
e
requisi
te
te
st.
The
res
ults
of
the
no
rm
ality
te
st
can
be
seen
in
T
a
ble
8.
Ta
ble
8
sho
ws
that
not
al
l
va
riables
have
a
sig
nificanc
e
va
lue
hi
gh
e
r
tha
n
0.0
5
(
p>
0.05)
.
It
ca
n
be
sta
te
d
that
t
he
res
ults
of
t
he
pre
-
te
st
and
po
st
-
te
st
distribu
ti
on
we
re
not
e
ntirel
y
distribu
te
d
norm
al
ly
.
Hyp
oth
esi
s test
w
as t
he
n per
form
ed
us
in
g
the
W
il
co
xon si
gn
ed ran
ks
test
.
Evaluation Warning : The document was created with Spire.PDF for Python.
In
t.
J.
Publi
c He
al
th Sci.
IS
S
N: 22
52
-
8806
Hea
lt
h ed
uc
ation i
m
pr
ov
e
be
ha
vi
or
and sel
f
-
ef
f
ic
acy on pe
rsona
l
hy
giene
amon
g… (
Tit
ie
k H
id
ay
ati
)
397
Tab
le
8.
N
or
m
al
it
y t
est
resu
lt
s on kno
wled
ge
, atti
tud
e,
be
ha
vior
,
a
nd self
-
eff
ic
acy
on
per
s
onal
h
y
giene
(n
=
30)
Variable
Measu
re
m
en
t
Statistic
p
Kn
o
wled
g
e
Pretest
0
.82
6
0
.00
0
Po
sttes
t
0
.84
2
0
.00
0
Attitu
d
e
Pretest
0
.95
6
0
.25
0
Po
sttes
t
0
.85
4
0
.00
1
Beh
av
io
r
Pretest
0
.93
1
0
.05
2
Po
sttes
t
0
.40
3
0
.00
0
Self
-
ef
f
icacy
Pretest
0
.85
3
0
.00
1
Po
sttes
t
0
.82
9
0
.00
0
So
u
rce:
Pri
m
ar
y
D
ata,
2
0
1
9
3.4.
Ef
fects
of
he
alth
ed
uc
at
i
on
using
audi
o
-
visu
al
m
eth
od
s
on
per
so
n
al
h
ygie
ne
-
rel
at
e
d
kno
w
le
dg
e,
attitude
, beh
avior,
and
sel
f
-
eff
ic
ac
y
Eff
ect
s
of
healt
h
e
du
cat
io
n
us
i
ng
au
dio
-
visu
a
l
m
et
ho
ds
in
c
hi
ldren
with
inte
ll
ect
ual
disabili
ty
on
t
heir
per
s
onal
hy
giene
-
relat
ed
knowle
dge,
at
ti
tud
e,
be
ha
vior,
a
nd
sel
f
-
ef
ficacy
wer
e
sh
ow
n
in
T
a
ble
9.
Table
9
s
hows
that
the
m
ean
ra
nk
at
the
ti
m
e
of
the
pr
et
est
with
the
l
owest
value
wa
s
in
the
sel
f
-
e
f
ficacy
var
ia
ble,
an
d
t
he
hi
gh
e
st
valu
e
was
in
the
at
t
it
ud
e
va
riable.
The
m
ean
rank
value
at
the
postt
est
with
the
lowest
value
is
in
t
he
sel
f
-
ef
ficacy
va
ria
ble,
a
nd
t
he
highest
val
ue
is
in
the
be
ha
vi
or
v
ariable
.
T
he
m
ean
rank v
al
ue
at
the
pr
et
est
a
nd
postt
est
on
th
e
kn
ow
le
dg
e
va
riable
obta
ine
d
a
sig
nifica
nt
val
ue
of
0.0
06
(p
<
0.0
5),
it
can
be
sta
te
d
there
wa
s
an
e
ff
ect
of
he
al
th
ed
ucati
on
ab
ou
t
perso
nal
hygie
n
e
with
a
ud
i
o
-
visu
al
m
et
hods
on
kn
ow
l
edg
e
in ch
il
dre
n wit
h
intel
le
ct
ual
di
sabili
ty
.
Table
9.
Wilc
oxon si
gned
r
a
nks test
resu
lt
s
on
per
s
onal
h
y
gi
ene
-
relat
e
d
know
le
dg
e
, atti
tu
de,
be
hav
i
or,
and
pe
rs
on
al
s
el
f
-
ef
ficacy
hy
giene (
n=30)
Variable
Measu
re
m
en
t
Mean
Ran
k
p
z
-
sco
re
Kn
o
wled
g
e
Pretest
9
.17
0
.00
6
-
2
.75
8
Po
sttes
t
1
3
.61
Attitu
d
e
Pretest
1
2
.35
0
.18
3
-
1
.33
1
Po
sttes
t
1
4
.22
Beh
av
io
r
Pretest
1
0
.32
0
.29
2
-
1
.05
4
Po
sttes
t
1
4
.35
Self
-
ef
f
icacy
Pretest
7
.00
0
.22
5
-
1
.21
3
Po
sttes
t
7
.78
So
u
rce:
Pri
m
ar
y
D
ata,
2
0
1
9
The
i
ncr
ease
in
knowle
dge
t
ha
t
occurs
i
n
m
ental
ly
disabl
ed
c
hildr
e
n
a
fter
be
ing
giv
e
n
healt
h
e
du
cat
io
n
is
due
to
dail
y
expos
ur
e
to
their
hygie
ne
act
ivit
ie
s.
A
fe
w
hours
a
f
te
r
bei
ng
gi
ve
n
healt
h
e
duc
at
ion
,
m
ental
ly
disab
l
ed
c
hildr
e
n
i
ndirect
ly
pract
ic
e
the
res
ults
of
the
knowle
dg
e
they
ha
ve
acq
uire
d
at
s
chool.
This
is
suppo
rted
by
pre
vious
researc
h
,
wh
ic
h
sta
te
s
that:
increasin
g
stu
de
nt
know
le
dg
e
a
fter
bein
g
giv
e
n
healt
h
edu
cat
io
n
is
du
e
to
m
easur
em
ents
m
ade
at
the
en
d
of
m
enstru
at
io
n.
Stu
de
nt
s
sti
ll
re
m
e
m
b
er
the
proce
dur
e
for
m
ai
ntaining
th
e
cl
eanli
ness
of
the
re
producti
ve
or
gan
s
beca
us
e
they
had
ju
st
pr
act
ic
ed
cl
e
anin
g
the
orga
ns
[
16
]
.
Pr
e
vious
rese
arch
sta
te
s
th
at
there
is
a
n
e
ff
ect
of
r
epeate
d
base
ba
ll
gam
e
te
chn
iq
ues
on
inc
reasin
g
the
gross
m
otor
s
kill
s
of
child
re
n
with
m
il
d
m
ental
retarda
ti
on
U
ng
a
ra
n
S
pecial
S
chool
.
Sign
i
ficant
im
pro
vem
ent
occu
r
red
in
se
ve
ra
l
aspects
of
gro
ss
m
oto
r s
kill
s
s
uc
h as
walki
ng,
run
ning, t
hrow
i
ng,
cat
ching, a
nd
hi
tt
ing
, but t
he g
ro
ss
m
oto
r
that
did n
ot a
ff
ect
was j
um
pin
g,
jum
pin
g,
a
nd
kicking
[
24
]
.
Coordi
nation
of
e
ye
a
nd
hand
m
ov
em
e
nts
is
the
e
xc
el
le
nt
m
oto
r
abili
ty
that
ap
pea
rs
i
n
the
dev
el
op
m
ent a
nd gr
ow
t
h of chil
dre
n when t
hey are
acti
ve, especia
ll
y i
n
m
il
dly reta
rded c
hildre
n. C
hi
ldre
n
can
easi
ly
carr
y
ou
t
daily
act
ivit
ie
s
if
their
e
ye
and
ha
nd
c
oor
din
at
io
n
a
re
excell
ent
an
d
vi
ce
ver
sa
if
t
he
ir
ey
e
and
ha
nd
c
oor
din
at
io
n
a
bili
ties
are
li
m
it
ed,
m
aking
it
dif
ficult
f
or
child
re
n
to
pe
rfo
rm
daily
ta
sk
s.
Fi
ne
an
d
gross
m
oto
r
ski
ll
s
that
are
tra
ined
an
d
car
rie
d
out
rep
eat
e
dly
will
m
ake
it
easi
er
for
c
hild
ren
to
do
thei
r
daily
act
ivit
ie
s.
Ba
sed
on
this
resea
rch,
act
ivit
ie
s
carried
out
fr
e
qu
e
nt
ly
can
al
so
be
a
ppli
ed
m
ai
n
ly
in
condu
ct
in
g
per
s
onal
h
y
giene
[
24
-
25
]
.
Indivi
du
al
s
w
ho
e
xp
e
rience
i
ntell
ect
ual
dis
abili
ti
es
or
dis
abili
ti
es
are
vu
lnera
ble
to
hea
lt
h
haza
rds
ei
ther
as
a
di
r
ect
conseq
ue
nc
e
of
their
in
abili
ty
or
du
e
to
a
la
c
k
of
aware
ness
re
gardin
g
perso
nal
an
d
env
i
ronm
ental
hy
giene.
Devel
op
m
ental
ch
il
dr
en
are
n
ot
awa
re
of
pe
r
so
na
l
hygiene
at
the
sc
hool
le
vel
.
Fo
r
bette
r
kn
owle
dge
a
nd
pr
act
ic
e,
healt
h
e
du
cat
io
n
i
nter
ve
ntion
pro
gra
m
s
are
essenti
al
for
gr
ow
i
ng
c
hildr
e
n
for
thei
r bett
er
healt
h
a
nd futu
re
[
10
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SSN
:
2252
-
88
06
In
t.
J.
Publi
c He
al
th Sci. V
ol.
8
,
No.
4
,
Dece
m
ber
201
9
:
39
1
–
3
99
398
This
re
searc
h
has
al
s
o
a
pp
li
ed
the
nur
sin
g
theo
ry
that
ha
s
bee
n
pu
t
forw
a
rd
by
No
la
J.
Pe
nder
,
nam
ely
Healt
h
P
ro
m
otion
M
od
el
(
HP
M
)
.
H
PM
in
this
st
udy
is
to
prov
i
de
he
al
th
e
ducat
ion
usi
ng
a
udi
ov
is
ual
m
et
ho
ds
f
or
m
ental
ly
disabl
e
d
c
hildr
e
n.
T
he
su
cces
s
of
the
m
et
ho
d
us
e
d
w
il
l
be
cl
os
el
y
re
la
te
d
to
t
he
be
ha
vior
of
res
ponde
nts
in
t
he
past,
s
uc
h
as
par
e
ntin
g,
r
ole
m
od
el
s,
patte
rn
s
of
dail
y
ha
bits.
Othe
r
facto
rs
are
pe
r
so
nal
factors:
bio
l
og
i
cal
factor
s
s
uc
h
as
a
ge,
gende
r,
a
nd
c
hildr
e
n
with
intel
le
ct
ua
l
disabili
ti
es;
ps
yc
holo
gical
f
act
or
s
su
c
h
as
m
otivati
on
a
nd
sel
f
-
com
petence;
and
s
ocioc
ultu
ral
fact
or
s
suc
h
as
race
an
d
ec
onom
ic
sta
tus.
Th
ese
facto
rs
play
cl
os
e
r
ole
in
the
s
uccess
of
t
he
m
et
ho
ds
us
e
d
in
deliv
erin
g
healt
h
ed
ucati
on.
T
he
hi
gh
e
r
sel
f
-
ef
ficacy
will
lowe
r
t
he
in
hib
it
in
g
facto
r
in
s
hap
i
ng
be
ha
vi
or
a
nd
prac
ti
ci
ng
be
ha
vi
or
i
n
healt
h
e
ducat
io
n
[
26
]
.
In
te
r
pe
rsonal inf
l
uen
ce
, th
at
is, f
am
ily sup
port in
the
form
of
the
fam
ily h
el
ps
f
il
l i
n
the co
nt
ro
l s
hee
t
wh
il
e
m
on
it
or
i
ng
t
he
im
ple
m
entat
ion
of
r
outi
ne
per
s
onal
hy
giene
act
ivit
ie
s
an
d
sit
uatio
nal
infl
uen
ce
s
are
two
influ
e
nces
that
can
directl
y
or
ind
irect
ly
in
flu
ence
t
he
be
havi
or
of
m
ental
ly
disa
bl
ed
child
r
en
t
o
pr
act
ic
e
or
not
pr
act
ic
e
t
he
he
al
th
ed
ucati
on
that
has
been
de
li
ver
ed
.
K
nowled
ge
ac
quire
d
by
a
n
i
ntell
ect
ually
disable
d
c
hild
will
af
fect
behavio
r
a
nd
at
ti
tu
des
,
wh
il
e
sel
f
-
eff
ic
acy
or
sel
f
-
co
nf
i
den
ce
i
n
the
a
bili
ti
es
of
the
m
ental
ly
disabl
e
d
child
will
aff
ec
t t
he
chil
d'
s
be
hav
i
or
[
27
-
2
8
]
.
Ther
e
wer
e
s
om
e
lim
it
at
ion
s
to
this
stu
dy.
T
his
st
ud
y
was
on
ly
done
for
f
our
days.
It
s
houl
d
be
eve
n
longer
,
but
du
e
to
the
c
on
st
raint
s
bet
wee
n
the
tim
e
of
r
esearch
al
m
os
t
cl
os
e
to
the
sche
du
le
of
st
ud
e
nt
exam
inati
on
s.
The
ot
her
lim
itati
on
was
that
the
s
am
ple
ta
ken
is
the
m
ini
m
um
sa
m
ple,
w
hi
ch
is
30
res
pond
e
nts
,
du
e
to
restric
ti
on
s
in
obta
ining
sam
ples
that
m
at
ch
the
inclusi
on
c
rite
r
ia
.
Othe
r
tha
n
that,
the
stu
dy
was
cond
ucted
in
on
e
cl
ass
that
was
com
bin
ed
with
c
hild
ren
with
dif
fer
e
nt
disa
bili
ty
cat
egories,
f
or
e
xam
ple
stud
e
nts
with a
utism
,
so
that
m
ade o
the
r
st
udents
less f
oc
use
d
.
4.
CONCL
US
I
O
N
This
re
searc
h
c
on
cl
ud
e
d
t
hat
the
a
ud
i
o
-
visu
a
l
m
et
ho
d
us
e
d
for
healt
h
ed
uc
at
ion
on
pe
rsonal
hy
gien
e
c
ou
l
d
af
fect
in
tim
a
te
hygiene
-
relat
ed
knowl
edg
e
on
c
hildre
n
with
intel
le
ct
ual
disa
bili
ty,
but
no
sig
nif
ic
ant
eff
ect
s
fou
nd
on
at
ti
tud
e,
be
ha
vior
,
a
nd
sel
f
-
eff
ic
acy
.
Atti
tud
e
a
nd
sel
f
-
e
ffi
cacy
on
perso
nal
hy
giene
w
ere
i
n
low
cat
e
gory,
wh
il
e
the
res
ponse
was
on
th
e
pr
act
ic
e
d
typ
e
.
It
is
rec
omm
end
e
d
t
o
co
nd
uct
f
ur
t
her
rese
arch
t
o
identify
the
ri
gh
t
st
rategy
in
giv
i
ng
pro
fes
sion
al
healt
h
e
du
cat
io
n
on
c
hildr
e
n
with
di
sabili
ti
es
with
m
or
e
exten
ded
stu
dy
per
i
od
s
.
W
e
r
ecom
m
end
e
d
to
sch
ool
s
to
prov
i
d
e
co
ntin
uous
healt
h
ed
uc
at
ion
f
or
st
u
de
nts
an
d
par
e
nts
on k
ee
ping
per
s
onal
hygiene
.
ACKN
OWLE
DGME
NT
This
wor
k
was
sup
ported
by
Mi
nistry
of
Re
search
Tec
hnol
og
y
a
nd
High
er
E
du
c
at
ion
Re
public
of
Ind
on
esi
a
[
Num
ber
7
/E/
KP
T/
2019
].
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NCE
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it
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l
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on
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al
Persona
l
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gi
ene
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eha
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r
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al
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f
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ic
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n
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AA
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le
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e
a
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y
gi
en
e
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y
Re
ta
rde
d
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e
nts
a
t
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Fikr
y
a
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in
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nia
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ía
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M
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d
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pac
t
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en
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ic
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ent
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e
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